Guest Editorial

Citation

Ashton, J. and Edwards, H. (2020), "Guest Editorial", Journal of Public Mental Health, Vol. 19 No. 3, pp. 197-198. https://doi.org/10.1108/JPMH-09-2020-108

This special issue focuses on a range of issues surrounding challenges of ageing which, despite increased life expectancy, have in many countries not been given the priority they deserve.

With the restrictions imposed to control the spread of COVID-19, many of us have experienced some of the barriers commonly faced by elderly people on a regular basis, especially those associated with social life and activity outside the home. In normal circumstances, consistent evidence links social isolation to serious adverse health conditions, but in the current crisis, social isolation prevents an even greater risk of mortality. It is generally assumed that younger people find more ways to overcome these barriers, for example by using social media. Studies are currently being carried out into the psychological effects of lockdown, perhaps one of the most comprehensive being that led by University College London: COVID-19 Social Study (Fancourt et al., 2020). Early results suggest that Some people who were already at risk for being lonely (e.g. young adults who are 18–30 years of age, people with low household income and adults living alone) experienced a heightened risk during the COVID-19 pandemic compared to usual (Bu et al., 2020) These results are consistent with Jerome Carson’s in this issue: a comparison between older and younger people on one day, around the time when restrictions were being introduced. Interestingly, on nearly all the measures, older people appeared to be less affected by the changes.

Ageing is of course not a simple measure of how old a person is. Those at extremes of social exclusion, having no place to call home, age prematurely. Emily Player’s paper on Trimorbidity refers to the combination of physical ill heath, mental ill health and substance misuse which may lead to early ageing or death. Those who are street homeless carried a higher risk for psychotic illness at 50–100 times that of the general population. A life course approach would be of much more benefit to such individuals than the piecemeal treatment which tends to be the default.

During the COVID-19 crisis, we have become familiar with daily publication of number of cases and other related statistics. The possibility of producing comparable figures, national and regional, for people living with dementia could be transformative in leading to more equitable provision of care. A recently published study gave a much better idea of the numbers of those with dementia as yet undiagnosed (Aldus et al., 2020). Clare Aldus, with a public contributor and a patient and public involvement (PPI) lead in the Research Design Service, is one of my three interviewees on the subject of PPI in research on ageing and dementia. Many people would recognise the situation described by Clare: During my working life, I have seen PPI go from zero consideration and zero support to absolutely essential in every way.

Mahtab Alizadeh-Khoei describes another approach to assessing the needs of the elderly and examines whether the Instrument of Daily Living scale can usefully and validly be applied to the Iranian context. This investigation could set an important pattern for use in other cultures.

In recent years, there has been increased interest in non-pharmacological ways of enhancing life for the elderly and those living with dementia. Heather Edwards describes a project training care home staff to work with residents to co-produce simple personal resources of significant sound, words and music to give comfort and sustain identity over time.

A creative application of the arts, in this case through writing is a collaboration between Norwich School, the University of East Anglia and Dying Matters, a coalition which aims to help people talk about dying, death and bereavement. Jessica Blake and Guy Peryer find that the subjects of loss, death and dying are by no means ones that young people or teachers wish to avoid. Creative storytelling presented by school students at a Dying Matters event demonstrated that this can be an important and feasible way to support children and families affected by loss and bereavement.

Nicholas Leigh-Hunt, who has published a review on social isolation (Leigh-Hunt et al., 2017), examines the benefits of a relatively simple change to the routine checks carried out by a Town Council on all their flats and houses. In addition to inspecting the condition of the properties, tenants were asked about their well-being, with interesting and significant outcomes.

The loneliness and isolation experienced by many older people can contribute to an increased dependence on alcohol. Rahul Rao’s review explores this problem and highlights the need for greater investment of time and money in an area currently given low priority.

T.S. Eliot encapsulates in a few lines, from Four Quartets, positives and negatives about old age:

Old men should be explorers

Here and there does not matter

We must be still and still moving

Into another intensity

For a further union, a deeper communion

Through the dark cold and the empty desolation,

The wave cry, the wind cry, the vast waters

Of the petrel and the porpoise. In the end is my beginning

((East Coker)